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Protect Your Plan’s Integrity Between Full Dependent Audits

To enable payers to continue mitigating risk long after the initial audit has been completed, Consova offers highly customizable Ongoing Dependent Eligibility Verification services. Statistics show that upwards of 40% of dependents who are initially identified as ineligible are re-enrolled during the next open enrollment. Approximately 80% of these individuals still do not qualify as legal dependents, leading to substantial risk exposure for the employer and an erosion of the savings generated from the initial audit. This is why Ongoing Dependent Verification is so important.

Identifying 8-10% of Dependents as Ineligible on Average

In order to reduce costs and protect your initial investment, constant dependent eligibility verification is necessary. Any time a dependent is added to the plan, they should be subject to the same strict standards of dependent eligibility verification, whether during open enrollment or during a qualifying event change.

Consova’s Ongoing Dependent Eligibility audit services verify dependent eligibility in an ongoing manner. We do this through a continuous review of new hires, post open enrollment, as well as periodic re-review of certain dependent classifications. Additionally, we monitor for employees with life event status changes.

Periodic Spouse Re-Reviews

High divorce rates, coupled with the high costs of offering coverage for dependent spouses, lead to significant risk exposure for employers. To mitigate this risk, employers should conduct a comprehensive spouse re-review for any spouse not audited in the past 18-24 months. On average, Consova finds 8-12% of enrolled spouses to be ineligible during a spouse re-review.

Working Spouse Provision Verification

Consova’s Working Spouse Provision audit enables employers to boost participation in the rule by 300% or more by confirming the availability of coverage directly with a spouse’s employer. Learn how your plan can achieve 30% participation in its spousal surcharge or exclusion rule.